Saturday, November 03, 2007

Markos "Screw 'em" Moulitsas Zunigas (aka Kos) has this story about Blue-Cross, Blue-Shield which further illustrates (to me) why our current system is messed up and answer isn't more government involvement, but less. On to the specifics:

Blue Shield, scum suckersby kosThu Nov 01, 2007 at 12:17:27 PM PDT

My daughter was born on April 7th of this year. We went to Alta Bates hospital, in Berkeley, which was pre-approved by our insurance provider, Blue Shield.

At the hospital, as is often the case in baby deliveries, my wife asked for and received an epidural. There was one Anesthesiologist in the entire hospital.

That anesthesiologist charged $1,032 for his services, which was passed on to Blue Shield.

One anesthesiologist in the entire hospital? And I wonder if Markos was aware of that price tag before the procedure. Given that the majority of us who are "customers" in the health care system are never told of costs, I'll assume that this was the situation here.

After an initial refusal to pay, followed by several weeks of back and forth, they sent a letter dated May 14th that says:

This is in response to your inquiry concerning services provided by East Bay Anesthesiologist on April 07, 2007 in the amount of $1,032.00.

You contacted us to request that claim process at the preferred rate. After careful consideration of this matter, we will, in this instance only, administratively approve payment for the above mentioned services. The claim(s) in question will be processed and an Explanation of Benefits will be sent shortly for you.

Please be advised that our determination in no way alters the terms and conditions of the subscriber's plan. In making this decision, we do not waive any of our rights to enforce the provisions of the subscriber's plan on this or any other service plan or claim.

Well, that ended well, didn't it? Of course not. This is the modern medical system we're talking about.

Since that time, Blue Shield paid about $400 of that total, and refuses to pay the rest. Meanwhile, the anesthesiologist's office keeps threatening to send us to collections. We've literally called Blue Shield several times every single month since May, asking why they wouldn't pay the balance. Each time, they assured us they would.

Then today, a service rep said they would pay no more. They said that this sentence applied:

You contacted us to request that claim process at the preferred rate.

Their out is the line "preferred rate". And the preferred rate for that procedure was apparently around $400.

Of course, we never asked them to process this at the "preferred rate". We ask them to pay for the service. That's why we're paying over $800/month in insurance premiums. To be insured.

It gets worse, the office of the anesthesiologist has letters from Blue Shield claiming that the insurance company had sent us the money directly, so to bill us for the services. Of course, we never received such money. No such checks were ever cashed (which would be easy enough to verify if they were really interested in the truth, and not shirking their duties).

It'd be great if Kos could get a copy of those letters and post them on the blog... wonder if he's actually seen them or if this is just the anesthesiologist making it up?

So they lie to us, claiming for seven months that they'll cover the procedure. They lie to the anesthesiologist's office, claiming they've already paid us the amount owed, and to bill us directly.

And now, finally, they truth comes out -- they have a problem paying what's owed and will refuse to do so, even though they sent us a letter saying they would.

At the preferred rate, which they paid.

I obviously don't know the specifics of the Moulitsas's's's health care plan, but I bet this is an in-network vs. an out-of-network issue or that the particular hospital that they went to simply didn't agree to their health plan's rates.

As my wife tried to deal with Blue Shield, she asked the costumer service rep what her name was. She said, "Diane." My wife asked for her last name. The woman said, "I don't have to give you that!"

Then she hung up.

Nice.

How could a government-run service be any worse than these unaccountable, unethical, disgusting creeps?

I can't wait to see all the stuff they'll refuse to pay over my abdominal pain.

If you think BlueCross, BlueShield is unaccountable, wait until you get the federal bureaucrat telling you they won't pay the claim. I heard this on one Lefty blog, where the commenter (responding to my recommendation that we need a freer market for health care) said that the government is accountable because they can get voted out of office.

I don't know about you, but if I get crappy service at a business, I don't have to wait 2, 4, or 6 years to "send a message" to the owner. I simply don't go there anymore (and perhaps let them know the reason). Businesses have to keep their customers happy if they want to stay in business. The government doesn't have to keep anyone happy. And the fact that your choice in employer provided insurance plans is probably limited to 3 and you only get to switch plans at a specific time of the year isn't that much different.

Finally, I'd like to point out something... Markos pays $800 per month for his plan, or $9600 a year. I assume that it's some full coverage, copay-only plan for two reasons: 1) the rate would suggest that; 2) Markos seems to be the type of guy (based on his political leanings) that would rather spend a fortune to protect against every conceivable event rather than obtain coverage for unlikely events and pay for common services - he likes the warm security blanket.

What if Markos had instead bought a Health Care Savings Account (HSA) with a High Deductible Health Plan (HDHP)? His premiums would be significantly lower, since he would only be insuring for unlikely, high-cost events. Granted, he knew he was going to have a baby this year, which certainly is a high cost event (*cough cough*). But, let's assume that he purchased one of those plans with a and contributed the same amount he's currently paying into the savings account.

Using Kos' b-day (and assuming his wife is near the same age) and zip code (Berkeley), here are some quotes for Kossack Prime.

For $221/month, he gets

$5k Family deductible (or a $2700 deductible for individual)

no charge preventative care visits

no charge on meds (Generic or Brand name) once the deductible is hit (which drug costs apply toward)

No charge hospitalization after deductible

No lifetime maximum payments by the insurance company

So, let's assume that the Kossacks had been contributing to this plan when he started The DailyKos, back in 2002, covering he and his wife.

I don't know the health care costs that Markos & his wife typically encounter, so the numbers below are simply for illustrative purposes.

2002Beginning HSA Balance: $0Premiums: $221 x 12 = $2,652Est Healthcare costs - $2,000 (being only 31 at the time, I assume that he's not spending a lot of time with the doctors. $2k is probably a high estimate.Total cost: $4,652HSA Remaining Balance: $9,600 - $4,652 = $4,948

Keep in mind that all of these amounts were contributed and paid out tax free, so that's an additional benefit for the Zunigas. It also doesn't account for the interest (3%?) that he would earn in his account each year.

Had Markos began an HSA even earlier, his savings account would be even larger. But, it should be noted that even with the delivery of a baby, Markos has $25k in his HSA.

And, I should point out that this shows that Markos isn't that smart of a consumer. He pays $9,600 in premiums a year, plus has to pay out of pocket copays (using already taxed income). The plan that I just found for him would only cost him a maximum of $7,2652 a year ($2,652 + $5,000 deductible).

And there are of course 18 different plans available, with varying degrees of coverages, deductibles, and premium costs. I selected the one above simply because it was pretty straight-forward, had an acceptable deductible and corresponding premium.

And, of course there are 29 competing HSA/HDHP plans in my area and one that provides coverage similar to the one I selected for Markos in Berkeley is only $147 per month, so his HSA would grow even more if he were lucky enough to live in the Show-Me State.

But, instead of understanding this simple reality and choosing a free-market solution that, if expanded to more people, would reduce the cost of health care (since the people paying would be spending their own money and ask how much it costs before agreeing to pay), Markos simply uses his specific circumstance to push for a more centralized, more bureaucratic approach to health care.

Regarding spending your own money instead of someone elses - Nobody spends somebody else's money as carefully as he spends his own. Nobody uses somebody else's resources as carefully as he uses his own. So if you want efficiency and effectiveness, if you want knowledge to be properly utilized, you have to do it through the means of private property.

Thursday, November 01, 2007

No wonder the GOP (and I) have such difficulty in discussing Social Security with the Left. I originally thought that they were simply a bunch of ostriches with their heads stuck in the ground, unwilling to consciously admit that the program had actuarial problems due to the demographics of our country and the specifics of the program. I had assumed that they subconsciously understood the issues, but just weren't willing to admit it, out of fear that the GOP might score some political points.

In fact, the problem isn't that they are just convincing themselves that the program is fine - the problem is that they don't even understand the problem or how social security works. Instead of ostriches (who, while they have their heads in the sand, at least know the reason for blinding themselves to the obvious danger), the Left are a bunch of single-celled organisms that have no clue about their external environment.

I said last night that I disagreed with the oft-stated claim that it just gets harder to 'fix' the non-existent Social Security crisis the longer you wait. In fact, as I thought about Obama's proposal to remove or retool the cap on Social Security taxes I got to thinking that it's not just not necessary to do right now but that it actually might be a bad idea altogether.

Many have argued that having this debate at all buys into the right-wing argument that there's a 'crisis' that needs to be solved and thus that the politics are all wrong. But put that aside, let's talk about whether it makes sense even on substance.

Despite the fact that FDR envisioned it as a temporary program... despite the crushing demographics of the baby boom, which means that there'll soon be more retirees receiving Social Security checks than workers contributing to the account.

More on the details in a bit...

When it comes to the policy and number-crunching nitty-gritty of Social Security I'm definitely an amateur. [ed - you don't say!] But I think I've got a decent sense of the political-economy of the question. We need to remember that now and for at least a decade into the future Social Security is actually subsidizing the rest of the federal budget.

First, I should tell Josh that this isn't a new development. Social Security contributions have always subsidized the federal budget.

The program brings in much more than it pays out.

For now... at least, for the next few years.

As we all remember from the voluble debates two years ago, the surplus is being used to buy US government bonds which go into the Trust Fund. And that socked away money will keep the program solvent through the middle of this century as the baby boomers retire, and revenues in no longer cover promised payments out.

This is where Josh shows his ignorance in full. Let me explain Social Security using a simpler, down to earth example.

Let's say Josh and his 4 buddies each give Bob $100 for him to save for them until they get older. He promise them no specific rate of return, but is overly generous and tells them, "hey.. instead of just assigning a fixed rate of interest, we'll let it float with the annual wage increase. While this won't be a great return year over year, it's better than nothing!"

They agree and he proceeds to blow the $500 on booze, coke, and hookers - which isn't too terribly far from what most DC politicians do with the money.

Josh and the guys come back and ask how their money is doing and how it's growing. Bob tells them that every thing's fine, because he's printed up a pretty document which promises each of them $150 when they retire 20 years from now ($750 total). Sure, he hasn't invested the money in anything that will provide a rate of return, nor does he have their original investment on hand. But, they do have the pretty pieces of paper, right? And, he's forced other suckers to hand him his cash (which he spends on booze, coke, and hookers) as well.

20 years later and Bob is still spending the money on booze, coke, and hookers. He realizes that he still owes Josh & the guys that money. He open up my shoebox and pulls out the pretty pieces of paper and realizes that it never turned into cash. So, he whips out his pistol and mugs everyone he sees who's not retired until he comes up with the $750, plus the money he owes everyone else. Since there aren't that many people working, he has to get more than $150 from each of the people he mugs. Painful for the mugging victims, but it works.

If Josh and Co would've simply invested their money in an index fund, they would've been okay. Instead, they trusted a guy who can't stay within budget and forced that guy to mug someone else to pay for the obligation.

Back to Josh's post.

We've been doing that for about a quarter of a century.

The problem on the political side of the equation is that the enemies of Social Security have spent a couple decades arguing that the Trust Fund doesn't exist or that it is simply a bookkeeping device with no true financial meaning. If that's true, it means that American workers have spent the last twenty-five years using their payroll taxes to subsidize general revenues and make it easier to float big tax cuts for upper-income earners without getting anything in return..

Actually, we've spent the last 25 years floating idiotic pork-barrel projects and other outlandish programs which are not enumerated in the Constitution.

If we start pumping a lot more money into Social Security coffers now it will by definition go into more government bonds, which is another way of saying that it will go toward funding our current deficit spending. In fact it will enable more deficit spending and probably more upper-income tax cuts because it will make the consequences of both easier to hide.

If we want to push the buffer of the Trust Fund further out onto the horizon, then fiddle with payroll taxes when Social Security would need to start dipping into Trust Fund. In other words, in a decade or so. I see no reason why this approach doesn't work just as nicely then as it would now.

But it won't work now, despite what Sen. Obama would like you to believe.

The problem with removing the cap on Social Security taxable income is that that money then becomes a larger future obligation for future generations - one big ponzi scheme. Unless of course you're going to tax wages all the way up and not stipulate that they'll be set aside for that person's future social security benefits - which, while done legislatively, is still a mugging.

Here's how it'd work:

Hey worker, I'm going to take 20% of what you make up to $95k and "invest" that for you... *snicker snicker... where's my crack pipe?*

Everything you make over $95,000, I'm going to tax at 20% and pay to all the people I promised to pay 30 years ago. You don't know them, but they sure appreciate it.

And if you think that the economy can grow out of the Social Security problem, keep in mind that benefits are tied to the wages, and any change (cough reduction cough) in that formula means that you're cutting benefits for the elderly - political suicide.

Raise the retirement age? Why, it's a good idea, what with people living longer and all. But many will feel that this too is cutting benefits for the elderly, since people will have to live longer in order to get their benefits. And the unfortunate millions who may not reach the new retirement age...

As Paul Krugman noted in the interview I did with him a few weeks ago, the window of time we had to seriously pare down the national debt to prepare for the retirement of the baby-boomers is close to over. Still, though, our best way of ensuring the future health of Social Security is to stop running up the national debt now. So I'm very reluctant to put more payroll taxes in the pot while we're still running big deficits because of the Bush tax cuts. The money will just go to subsidizing that irresponsible fiscal policy.

You interviewed Krugman? Perhaps you should've take an Econ 101 course, first.

Josh - You may not realize this, but federal tax receipts are at record highs, so no need to tinker with the tax rates - unless you plan on lowering them to increase the amount of money hitting the books thanks to an improved economy.

If you'd like to reduce the federal debt, I'd recommend that we start cutting the spending. Because, for every government program with a projected expense, you know that the amount will be likely higher. You may not know the degree, but you know the direction in which the expense will be in relation to the projection. If the program didn't exist, the expense wouldn't exist. Then, we could take the money and cover the future outlay.

Or, better yet, allow the youth of the country to start investing in conservative index funds, allowing for the Time Value of Money to work its magic and provide a substantial sum in their retirement years. The feds might have a short-term crunch as the Boomers retire, but there will be a light at the end of the tunnel as those without the defined benefits of Social Security start to approach retirement. It will be painful, but at least people's retirements would be secure indefinitely.

If there is any sense in which the 'Trust Fund' is not 'real' it is that it must be paid back from general revenues. And that will only be harder the more other debt we're running up. So rather than solving the problem, I think we're actually enabling it.

The second problem is that we need a national agreement or consensus that the Trust Fund is real, that it will be honored, and have the debate about the future of the program on that basis. Otherwise, we're still risking getting played in the same bait-and-switch privatizers have been trying to pull for years -- using regressive payroll taxes to fund current government spending and then telling future recipients that that money has disappeared and thus Social Security has to be phased out altogether.

Lifting the payroll tax cap while Social Security is still running a big surplus not only solves a problem that doesn't exist it enables the very policies that put the program in danger. Perhaps this is all another way of saying that I'm not a fan of putting more hens in the hen house while the foxes are still at the door, or even in the house.

I'm interested to hear your thoughts.

I assume that you think the GOP tax cutters are the foxes, but you do realize that it's spending that's out of control, right? More government programs and the requisite higher taxes are not the solution.

That'd be like telling Bob that the solution to his inability to budget properly is that he hasn't had enough booze, coke, or hookers and that if he could just mug a few more people a day he'd become a millionaire in a week.

Chris Hitchens is not a conservative. I doubt there's are many issues on which Chris would agree with Antonin Scalia, Clarence Thomas, Buckley, etc - all of whom are listed as being less influential than Hitchens.

Andrew Sullivan is not a conservative. I would guess that supporting John Kerry and Barack Obama in the presidential elections would disqualify you from being a conservative.

Joe Lieberman is not a conservative. Even if he were in the GOP, he wouldn't be #47 of the Top 100 most influential conservatives.

Unless of course the Telegraph's definition of being conservative is someone who recognizes the Islamist threat and being pro-war at some point in the last 5 years. If that's the barometer, I hate to say that you have no f-ing clue what you're talking about.

Other items to note - Conservatives who are profiled who are not influential, such as Larry Craig. Beyond his bathroom antics, who outside of Washington have ever heard of this guy?

Tuesday, October 30, 2007

Bawdy Halloween costumes, however, have become the season's hottest sellers in recent years. Not just for women, but for girls, too. And parents such as Cirenza don't like it.

Gabby eyed the Sexy Super Girl but decided against it. A friend at her Catholic school had worn that costume for a Halloween parade and pulled the already short miniskirt way up to cover her tummy. "That didn't look very good." But Gabby did like the Aqua Fairy, a vampy get-up with a black ripped-up skirt, black fishnet tights and blue bustier that comes in medium, large and preteen. A medium fits a child of 8.

No.

How about the Funky Punk Pirate Pre-Teen, with an off-the-shoulder blouse and bare midriff?

No.

Gabby pointed to the Fairy-Licious Purrrfect Kitty Pre-Teen, which, according to the package, includes a "pink and black dress with lace front bodice and sassy jagged skirt with tail. . . . Wings require some assembly."

Cheryl Cirenza shook her head in exasperated disbelief. "This is all so inappropriate. It's really disturbing," she said, eyeing a wall of such girl and preteen costumes as Major Flirt in army green, the bellybutton-baring Devilicious and a sassy, miniskirted French Maid, pink feather duster included. She'd just turned down her 13-year-old daughter's request for a Sexy Cop outfit. "When I was their age, I was a bunch of grapes."

But that was back in the days when Halloween was still a homemade kind of holiday, when an old sheet with eyeholes was a perfectly acceptable ghost and clumsily carved pumpkins on the front porch were about as elaborate as the decorations got. Now, Halloween is big business. Americans are expected to spend upwards of $5 billion this year on candy, ghoulish decorations and costumes. And the hottest trend in costumes, retailers say, is sexy. And young.

Fishnet tights, once associated with smoky cabarets or strip joints, now come in girls' sizes and cost $3.99.

Joe Thaler, head of TransWorld Exhibits Inc., runs the annual Halloween Expo for big-box retailers. He said suggestive costumes for girls burst onto the scene about three years ago and the phenomenon is so big that he's had to create a separate fashion show. The costumes have since moved to the plus-size market for adult women and now come in teen and preteen versions. Even little girl costumes show more leg and tummy than they used to. "They're just good sellers," Thaler said. [...]

Monday, October 29, 2007

Terrorists surrounding themselves with women, children, and Lefty Human Shields.The Moonbats over at Firedoglake are shocked - shocked - that the US military would dare strike a target in which it knew that civilian casualties might be the result. Here's an excerpt:

US Air Strikes in Afghanistan: A “Macabre Kind of Calculus”By: Scarecrow

CBS 60 Minutes revealed last night that the US military in Afghanistan uses air strikes in situations it knows will kill innocent civilians, if the commanders also believe enough Taliban might be killed. The result has been a doubling of civilian casualties, such that we now kill as many civilians as the Taliban and al Qaeda kill.

And all Afghan President Karzai can do is plead with George Bush, so far unsuccessfully, that the US stop using air strikes against civilian targets.

In one of many such incidents this year, US forces announced they had carried out an air strike and had killed several suspected militants. However, the military declined to provide further information on who might have been killed, and when reports leaked out that most of the victims had been women and children — innocent civilians — 60 Minutes sent a team to find out what happened.

In interviews with 60 Minutes, US military acknowledged that field commanders had clearance to call in air strikes on civilian targets, knowing that innocent deaths would likely occur, provided they made what one official described as a “macabre kind of calculus” about whether the “target” was “worth” the likely number of civilian deaths.

We learned there are two kinds of targets: deliberate targets which are analyzed for days and watched for patterns of civilians coming and going, and immediate targets, such as when troops are in combat and need air support. In both cases, civilian casualties are estimated in advance and it’s up to the commander on the ground to decide whether the strike is worth the cost.

“We rely on those commanders to make the assessment at the time of what the requirement is. He assesses proportionality. He assesses the validity of the military target,” Crowder explains. . . .

[...]

That an officer has to consider civilian casualties that could result from taking out the enemy - all the while under fire from the enemy - speaks to the character of our military personnel and the quality of their training. It also speaks to the restraint which they show while conducting military operations.

Now, civilian casualties are obviously unfortunate, but war isn't flag football. And the Left's attempt to compare Chimpy W. McBushitler and the military to terrorists is just ridiculous. Compare and contrast the following:

Terrorists actively seek out to slaughter innocent civilians

The US Military has a rational process for determining the cost/benefits of taking the military target out, with the goal being to limit civilian casualties - even when those civilians may be harboring and/or aiding the enemey

I know that many moonbats won't understand the distinction there, but I've got to make an attempt.

But, what is the result of such ridiculous criticism? What if the Moonbats were to be thrust into leadership positions on conducting the War on Terror (if they'd ever agree that we were actually at war in the first place)? What if they implemented Rules of Engagement which stated that no civilian casualties could be allowed, ever, ever, ever, ever?

And this goes to another point... the purpose of the Geneva Conventions that deal with illegal combatants (at least, those to which we are a signatory) are not there to protect the combatant - they're there to protect the civilian non-combatants.

When an enemy disguises himself in civilian garb and makes himself indistinguishable from civilians, it is no surprise that civilians are killed during war. The Geneva Conventions regarding illegal combatants require that they carry their arms openly, are distinguishable from the civilian population by uniform or other insignia, etc. The benefit of comporting oneself to the rules of civilized warfare as outlined in the Geneva Conventions is that you are provided protections should you surrender to your enemy.

Failing to follow the rules of the Geneva convention makes you an illegal combatant and you can be executed following a military tribunal to justify such a classification.

Surrounding yourself with women, children, and non-combatants, while at the same time dressing as a non-combatant will cause the deaths of you and the non-combatants.

And, we know it'll also cause the moonbats to squeal and call for a war crimes tribunal against Chimpy W. McBushitler.

It seems that those familiar with the health care systems in "enlightened" Europe are laughing at Michael Moore's ridiculous film about the glories of socialized medicine. From the Sunday Times (of London):

October 28, 2007

Quack Michael Moore has mad view of the NHSMinette Marrin

The fourth estate has always had a bad name, but it seems to be getting worse. Journalism should be an honest and useful trade, and often still is. But now that journalism has more power than ever before, it seems to have become ever more disreputable. In recent years it has been brought lower and lower by kiss-and-tell betrayals, by “reality” TV, by shockumentaries and by liars, fantasists, hucksters and geeks of every kind, crowing and denouncing and emoting in a hideous new version of Bunyan’s Vanity Fair.

Outstanding among these is Michael Moore, the American documentary maker. He specialises in searing indictments, such as Fahrenheit 9/11 and Bowling for Columbine, and has, without a doubt, a genius for it. Although his films are crude, manipulative and one-sided, he is idolised by millions of Americans and Europeans, widely seen as some sort of redneck Mr Valiant-for-truth.

Nothing could be further from the truth. His latest documentary, Sicko, was released in cinemas last week. Millions of people will see it and all too many of them will be misled.

Sicko, like all Moore’s films, is about an important and emotive subject – healthcare. He contrasts the harsh and exclusive system in the US with the European ideal of universal socialised medicine, equal and free for all, and tries to demonstrate that one is wrong and the other is right. So far, so good; there are cases to be made.

Unfortunately Sicko is a dishonest film. That is not only my opinion. It is the opinion of Professor Lord Robert Winston, the consultant and advocate of the NHS. When asked on BBC Radio 4 whether he recognised the NHS as portrayed in this film, Winston replied: “No, I didn’t. Most of it was filmed at my hospital [the Hammersmith in west London], which is a very good hospital but doesn’t represent what the NHS is like.”

I didn’t recognise it either, from years of visiting NHS hospitals. Moore painted a rose-tinted vision of spotless wards, impeccable treatment, happy patients who laugh away any suggestion of waiting in casualty, and a glamorous young GP who combines his devotion to his patients with a salary of £100,000, a house worth £1m and two cars. All this, and for free.

This, along with an even rosier portrait of the French welfare system, is what Moore says the state can and should provide. You would never guess from Sicko that the NHS is in deep trouble, mired in scandal and incompetence, despite the injection of billions of pounds of taxpayers’ money.

While there are good doctors and nurses and treatments in the NHS, there is so much that is inadequate or bad that it is dishonest to represent it as the envy of the world and a perfect blueprint for national healthcare. It isn’t.

GPs’ salaries – used by Moore as evidence that a state-run system does not necessarily mean low wages – is highly controversial; their huge pay rise has coincided with a loss of home visits, a serious problem in getting GP appointments and continuing very low pay for nurses and cleaners.

At least 20 NHS trusts have even worse problems with the hospital-acquired infection clostridium difficile, not least the trust in Kent where 90 people died of C diff in a scandal reported recently.[Ed - Read this post where Mark Steyn discusses C diff and why it's so prevalent in socialized health care systems.]

Many hospitals are in crisis. Money shortages, bad management, excesses of bureaucrats and deadly Whitehall micromanagement mean they have to skimp on what matters most.

Overfilling the beds is dangerous to patients, in hygiene and in recovery times, but it goes on widely. Millions are wasted on expensive agency nurses because NHS nurses are abandoning the profession in droves. Only days ago, the 2007 nurse of the year publicly resigned in despair at the health service. There is a dangerous shortage of midwives since so many have left, and giving birth on the NHS can be a shocking experience.

Meanwhile thousands of young hospital doctors, under a daft new employment scheme, were sent randomly around the country, pretty much regardless of their qualifications or wishes. As foreign doctors are recruited from Third World countries, hundreds of the best-qualified British doctors have been left unemployed. Several have emigrated.

As for consultants, the men in Whitehall didn’t believe what they said about the hours they worked, beyond their duties, and issued new contracts forcing them to work less. You could hardly make it up.

None of these problems mean we should abandon the idea of a universal shared system of healthcare. It’s clear we would not want the American model, even if it isn’t quite as bad as portrayed by Moore. It’s clear our British private medical insurance provision is a rip-off. I believe we should as a society share burdens of ill health and its treatment. The only question is how best to do that and it seems to me the state-run, micromanaged NHS has failed to answer it.

By ignoring these problems, and similar ones in France’s even more generous and expensive health service, Moore is lying about the answer to that question. I wonder whether the grotesquely fat film-maker is aware of the delicious irony that in our state-run system, the government and the NHS have been having serious public discussion about the necessity of refusing to treat people who are extremely obese.

One can only wonder why Sicko is so dishonestly biased. It must be partly down to Moore’s personal vainglory; he has cast himself as a high priest of righteous indignation, the people’s prophet, and he has an almost religious following. He’s a sort of docu-evangelist, dressed like a parody of the American man of the people, with jutting jaw, infantile questions and aggressively aligned baseball cap.

However, behind the pleasures of righteous indignation for him and his audience, there is something more sinister. There’s money in indignation, big money. It is just one of the many extreme sensations that are lucrative for journalists to whip up, along with prurience, disgust and envy. Michael Moore is not Mr Valiant-for-truth. He is Mr Worldly-wiseman, laughing behind his hand at all the gawping suckers in Vanity Fair. Don’t go to his show.

But, no worries. I have been repeatedly assured by the Nutroots that the problems of the British NHS and the Canadian health care system, the extreme costs of the French health care system, and the totalitarianism of the Cuban health care system do not exist.

They're all figments of my rabid, right-wing imagination. Regardless of the economics involved, the Left tells me that we can achieve utopia right here on Earth!

Record numbers of Britons are travelling abroad for medical treatment to escape the NHS - with 70,000 patients expected to fly out this year.

And by the end of the decade 200,000 “health tourists” will fly as far as Malaysa and South Africa for major surgery to avoid long waiting lists and the rising threat of superbugs, according to a new report.

The first survey of Britons opting for treatment overseas shows that fears of hospital infections and frustration of often waiting months for operations are fuelling the increasing trend.

Patients needing major heart surgery, hip operations and cataracts are using the internet to book operations to be carried out thousands of miles away.

Why would all of these people prefer the pay their private money (on top of the taxes they're paying for the NHS) for health care services in a foreign country instead of in their egalitarian British system?

The story continues:

Katherine Murphy, of the Patients' Association, said the health tourism figures reflected shrinking public faith in the Government's handling of the NHS.

"The confidence that the public has in NHS hospitals has been shattered by the growth of hospital infections and this Government's failure to make a real commitment to tackling it," she told The Sunday Telegraph.

"People are simply frightened of going to NHS hospitals, so I am not surprised the numbers going abroad are increasing so rapidly.

"My fear is that most people can't afford to have private treatment – whether in this country or abroad."

Ahhh... well, perhaps the British government should impose a law on these traitorous Brits and ban travel abroad for health care. I mean, that's money that could be invested in the NHS, right?

This final sentence in the story is just unbelievable:

Waiting times had fallen. Almost half of patients were treated within 18 weeks of seeing a GP. Most people who had hospital care did not contract infections.

Let me repeat... waiting times have fallen to 18 weeks on average.

See a GP... Wait 126 days to get the treatment. Or perhaps longer if you have something really serious where there are few specialists to meet the demand.

Woops... there I go with reality, again. I should simply embrace health care run by the likes of Barack and Hillary..